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Spinal arteriovenous fistulas (SAVFs) are the most common type of vascular malformation of the spine in adult patients. They can lead to acute or progressive myelopathy due to venous congestion of the medullary veins. While most SAVFs are acquired, their pathophysiology remains unclear. The natural history of the disease and its clinical presentation are highly influenced by the location of the fistula and various factors may trigger sudden neurological decline. We present a case of a patient who developed a complete spinal cord injury after a lumbar nerve root block, likely due to an undiagnosed SAVF. The patient underwent endovascular embolization, resulting in a complete recovery of neurological function.
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http://dx.doi.org/10.1177/15910199241276578 | DOI Listing |
Cureus
July 2025
General Internal Medicine, King's Mill Hospital, Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, GBR.
A man in his 70s with known vascular risk factors presented with acute onset of bilateral lower limb weakness and urinary retention. Initial spinal magnetic resonance imaging (MRI) revealed a longitudinally extensive myelopathy. It was initially interpreted as transverse myelitis, prompting treatment with high-dose corticosteroids.
View Article and Find Full Text PDFWorld Neurosurg
August 2025
Section of Neurosurgery, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia. Electronic address:
Background: Spinal dural arteriovenous fistulas (SDAVFs) are the most prevalent type of spinal vascular malformation and can lead to progressive neurological impairments if left untreated. Endovascular embolization and microsurgical resection are treatment options, although the optimal treatment method remains a subject of debate.
Objective: A comprehensive systematic review and meta-analysis to compare the endovascular and microsurgical treatment outcomes of SDAVFs.
Neuroradiol J
August 2025
Division of Neuroradiology, University Medical Imaging Toronto and Joint Department of Medical Imaging, University Health Network, Toronto Western Hospital, Toronto, ON, Canada.
Spinal epidural arteriovenous fistulas (SEAVFs) with intradural reflux are rare but important vascular lesions that may cause progressive myelopathy due to spinal cord venous hypertension. Although traditionally managed by means of arterial embolization or surgical disconnection, these approaches can pose risks, particularly when critical vascular structures, such as the artery of Adamkiewicz, originate in close proximity to the fistulous site. We report the case of a patient in their 60s who presented with progressive paraparesis over approximately 1 year, ultimately attributed to an SEAVF located adjacent to the right L1-L2 neural foramen, with radiculo-perimedullary reflux.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
August 2025
Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan.
Background: In dural arteriovenous fistulas, bridging veins are connecting vessels that drain venous blood from the surface of the brain to the surrounding dural sinus. It is rare for the fistulous point and the bridging vein to be at different levels.
Observations: A 71-year-old man presented with progressive spinal symptoms of 8 months' duration.
J Clin Neurosci
August 2025
Department of Neuropathology, Timone Hospital, 264, rue Saint-Pierre, 13 005 Marseille, France.